It's always a good idea to have a backup plan.
When it comes to avoiding pregnancy, an increasing number of women are turning to an emergency contraceptive called Plan B, which some professionals attribute to the drug's over-the-counter availability and to an almost 900 percent increase in the cost of some birth control.
"We use to give out a lot of Plan B prescriptions, because you had to go see a doctor," said Dr. Kelly Bennett, medical director of Tech's Student Health Services. "Now, people will generally go to the pharmacy or grocery store closest to them."
In August 2006, the U.S. Food and Drug Administration approved the emergency contraceptive drug Plan B, also referred to as the "morning-after pill," as an over-the-counter option for women aged 18 and older.
Sales of the drug have tripled since its over-the-counter release, said Barr Pharmaceuticals spokesperson Heather Ioset.
She said the ability to drive to the pharmacy and pick up a pack of the pills equates to "one less barrier."
Barr Pharmaceuticals reported an increase in its 2008 third-quarter earnings for its trademarked product sales, which brought in $133 million, about $8 million more than the same quarter last year. According to its Web site, the pharmaceutical company attributes the increased sales in part to Plan B and other contraceptives it produces.
Tony Thornton, CEO of Planned Parenthood in Lubbock, said the clinic has seen an increase of sales of emergency contraceptives, such as Plan B, since it became an over-the-counter drug, but the availability may not always be a good thing.
"Plan B is a temporary emergency contraceptive and not for continued use," he said. "And emergency contraception was never designed to be a birth control method."
Thornton said the clinic monitors how many times a person purchases the drug within a certain period of time and, if it becomes too frequent, a clinic worker will council the person to consider a birth control prescription.
Although oral contraceptives could be used for the same purpose, Bennett said, emergency contraceptives differ from its daily-dose cousins.
Emergency contraceptives contain the hormone trogestin, whereas birth control contains two hormones: trogestin and estrogen.
She said birth control primarily does two things.
"It stops ovulation if it's about to occur," Bennett said, "and it makes the uterus and the tubes inhospitable to sperm."
Trogestin produces fewer side effects than estrogen, she said. Estrogen has been known to cause several serious problems among people who have certain medical conditions.
For example, Bennett said, estrogen may cause stroke among people who have a history of migraines accompanying the visual distortion known as auras.
"We have to be careful about who gets the combination of hormones," she said. "'The pill' will never be over-the-counter because of those reasons."
Thornton said about four birth control pills will achieve the same effect as an emergency contraceptive, but people should contact a pharmacist before taking more than the recommended dose of their medication.
Federal grants provide reproductive health care centers or family planning services reimbursement for birth control, Thornton said, which allows people who qualify to purchase the contraceptive at little or no charge.
But he said a delay in renewal of federal contracts has caused an increase in the cost of birth control.
"The problem is the reimbursement for birth control pills is only $2.80 on one of the programs," Thornton said. "So regardless for what we pay for the pill, we only get $2.80. We're still able to provide as many people as we always have, but we lose money on most pills."
According to the Planned Parenthood Web site, the cost of birth control in many health centers has risen almost 900 percent. Women paying between $5 and $10 for birth control now pay as much as $40 or $50 for the same prescription.
Two years ago, Bennett said, Congress "eliminated" a provision in a law requiring pharmaceutical companies to offer cheap contraceptive drugs to health centers.
Some lawmakers have rallied for The Prevention Through Affordable Access Act, which would restore and protect access to Medicaid's discounted drug prices for university-based and safety-net clinics, but no major action has been taken since the act was referred to the House Committee on Energy and Commerce in 2007, according to the Library of Congress Web site.
Meanwhile many women many not be able to afford birth control - a problem Bennett said may contribute to the increased sales of emergency contraceptives.
Melanie Bixler, chief pharmacist at the Texas Tech Student Health Pharmacy, said the student pharmacy ordered 65 units of the emergency contraceptive Plan B for the fall semester. Six are currently in stock, but more can be ordered at any time.
Bixler said the emergency contraceptive's sales have decreased since becoming an over-the-counter product.
Students may have purchased more emergency contraceptives at Student Health Services when it was a prescription, Bennett said, because it was convenient to come to one place to both see the doctor and purchase the pill.
"If people would have condoms on hand, you wouldn't have to even worry about it," Bennett said. "Condoms break much less frequently and work much better than people think."
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